[ THEME VII ] How to use a hearing aid ?

This article is part of a series of articles about hearing aids and hearing. The summary of this special feature is available here. We are now addressing a set of questions regularly asked by Internet users, related to the daily use of a hearing aid or a hearing device. If the question you have is not covered in this article, please feel free to ask it in the comments and we will try to answer it as soon as possible.

How to use a hearing aid ?

If you purchased your hearing aid from a hearing care professional / an audioprosthetist, an explanation of how to use your hearing aid was provided by your hearing care professional. If you chose to purchase a preset hearing aid, a user manual was provided (in most cases, for serious companies) with your purchase. We therefore recommend that you first ask your hearing care professional / audioprosthetist for advice or refer to the user manual of your hearing aid, depending on your situation. If necessary, you can also contact the company that sold you a preset hearing aid directly (usually directly on the company’s website : contact > contact us).

Whether it is adjusted to your hearing loss or pre-configured to compensate for presbycusis, your hearing aid is used in the same way and may require a few days of adjustment for some people (especially in the case of an in-the-ear hearing aid, CIC).

The gradual adaptation to a hearing aid

During the first few days of using a hearing aid, the amplification of sounds – sometimes forgotten – may seem unpleasant for some people, who will complain of resonance, metallic sounds, a feeling of obstruction of the auditory canal or even, in extreme cases, headaches or fatigue. This is perfectly normal : it can take some time to get used to a hearing aid. For these people, it is recommended to increase the wearing time of the hearing aid every day. For example, for the first few days of use, wear your hearing aids for only an hour or two in situations that require it : in front of the television, in a restaurant, at a business meeting. Then, in the following days, increase the wearing time to 3 or 4 hours, always in situations that require it : listening to music, answering the phone, at the gym, in a social context. When you feel more comfortable with your hearing aid, you can then start wearing it for a full day. Some people, during this adaptation phase, immediately feel the comfort of the hearing aid and quickly adopt it ; for others, alternating a full day of wearing the hearing aid with a half day of wearing it may still be recommended, until the full benefits of the hearing aid are felt.

Difficult contexts for wearing a hearing aid

There are certain situations that can make it difficult to wear a hearing aid. Two things should be noted : the hearing aid is an imperfect solution that will never give you back the hearing you had in your 20s ; the hearing aid detects and reduces ambient noise, but does not consider sudden noises (a baby’s cry, for example), as an annoying noise to be reduced. Thus, wearing a hearing aid on the street, in a classroom where everyone is talking at the same time, in a schoolyard, in a situation where people are shouting, can make using your hearing aid unpleasant. Change the hearing aid program (mute high or low tones depending on the context) or remove it. In general, keep in mind that these situations are not more pleasant without the hearing aid and that the problem in these cases is not the hearing aid, but the noise generated by the situation itself. We should also add that some high-ceilinged rooms, in which there is – by their very configuration – a natural resonance, are not conducive to wearing a hearing aid (amplification of the resonance). Finally, as a general rule, hearing aids are not water resistant, so remember to remove them before taking a shower or going swimming, but also before applying hairspray, perfume or mosquito repellent, for example.

How long should I wear a hearing aid ?

Apart from the adaptation stage, which we have just mentioned, a hearing aid should ideally be worn all day long, from the time you get up until you go to bed. This is not a constraint, but rather the pleasure of finding hearing comfort in the most common situations of life. Certain situations can be considered :

• You live alone,
• Your hearing discomfort is at the beginning, slight (primo-presbycusis),
• You can’t stand your hearing aid.

Do I have to wear my hearing aid if I live alone ?

If you live alone, you may not see the point of wearing a hearing aid. Wear it when you go out, interact with colleagues or friends, engage in a social activity, turn on the television, radio, music, or have someone visit you, whenever the need arises. There is no point in wearing a hearing aid when you are alone or when there is no interaction around you.

Your hearing loss is mild (primo-presbycusis)

In the case of primo-presbycusis, certain situations are uncomfortable, such as understanding dialogue on television, for example, and it is not uncommon to have those around you (usually women and children) repeat themselves ; other situations, on the other hand, do not yet pose a problem. It is essential to use your hearing aid in moments of discomfort, as soon as the need arises, which allows a gradual habituation to the hearing aid.

You can’t stand your hearing aid

A hearing aid is meant to be worn, to provide hearing comfort : so you should not remain in a situation where you cannot stand your hearing aid.

If you have purchased your hearing solution from a hearing care professional, you have 30 days of free trial : if the tested solution does not suit you, take advantage of this time to change it and find the hearing solution that suits you. If you have purchased your hearing solution from a hearing care professional, the 30-day trial period has passed and you cannot stand your hearing aid : return to your hearing care professional, who will adapt the amplification of the hearing aid or the shape of the earmold to allow you to stand your hearing solution and wear it every day. When you purchase a hearing aid fitted by a hearing care professional, you also purchase an annual follow-up service for the life of your hearing aid : it is essential to return to your dealer to resolve your discomfort as soon as possible.

If you have purchased a pre-configured hearing solution on the Internet, you have a legal cooling-off period of 14 days to return your hearing aid if you do not like it. With some companies, this period is increased by 6 days (this is the case with SERINITI). On Amazon, the withdrawal period is 30 days. If you have purchased a pre-configured hearing solution, and the 14, 20 or 30 day period has passed and you cannot stand your hearing aid, contact the company directly, which can provide you with solutions to make wearing your hearing aid as comfortable as possible (such as changing the size of the earmold or reducing the amplification of sounds, for example).

Can I wear only one hearing aid ?

Whether it’s pre-configured or customized for your hearing loss, it’s perfectly fine to wear a single-sided hearing aid if :

Your hearing loss is greater than 30dB in one ear

The hearing loss (presbycusis) is progressive, bilateral and symmetrical : it is therefore generally identical in both ears. However, it is not uncommon for this hearing loss to be equal to or greater than 30dB in one ear and not in the other. However, the indication of hearing aid from an ENT doctor is given when the hearing loss is equal or superior to 30dB : in this case, only the ear concerned by a hearing loss equal or superior to 30dB will be fitted. We talk about :

• Unilateral fitting when only one ear is fitted,
• Bilateral fitting when both ears are fitted.

These mentions are visible on the medical prescription of the ENT doctor who performed the audiogram and the hearing tests.

Your hearing aid is an in-the-ear device (CIC hearing aid)

We have already mentioned this point in article 5 : an in-the-ear (CIC) hearing aid makes use of the anatomical capacities of the ear, which is a natural amplifier. Thus positioned in the auditory canal, the intra-aural hearing aid makes use of :

• Of the auricle which, by its shape of funnel captures the whole of the surrounding sounds and which, by its folds, makes it possible to spatialize them ;
• The auditory canal, which protects the microphone from wind noise ;
• The proximity to the eardrum, which allows a restitution without delay (immediate) of the sounds, that the ear is equipped or not (unilateral equipment).

Thus, if your hearing aid is an in-the-ear (CIC) device, the amplified sounds will be restored at the same time, from one ear to the other, which would not be equipped. In other words, unilateral hearing aids are possible and comfortable with an ITE / CIC device. It is, on the other hand, more complicated or, at least, less pleasant with a BTE device which, by definition, bypasses the ear, which generates a delay in the restitution of amplified sounds.

Please note : the purpose of a hearing aid is to provide listening comfort when hearing loss is present and not to prevent the aging of the ear. Thus, in the case of a unilateral hearing aid, the non-hearing ear will not age faster than the ear fitted with a hearing aid. On the other hand, since a unilateral hearing aid provides sufficient cortical stimulation, there is no medical contraindication to wearing only one hearing aid and, in the case of an individual who is reluctant to wear a hearing aid, it is always wiser to guide him or her towards a unilateral hearing aid (de-dramatization) than towards not wearing a hearing aid.

Can I wear a hearing aid with glasses ? How do you wear glasses with a hearing aid ?

It is perfectly possible to wear a behind-the-ear (BTE) or in-the-ear (ITE / CIC) hearing aid if you already have glasses. This does not pose any problem. However, there are a few things to consider.

The behind-the-ear (BTE) hearing aid and the pair of glasses

The behind-the-ear (BTE) hearing aid consists of a case that is placed behind the auricle and a sound tube that passes over the ear and ends in the ear canal, where the amplified sounds are delivered to the eardrum and the ossicular chain. The case is thus located on the auricle, under the branch of the glasses : at the end of the day, with tiredness, branches of the glasses and auditory apparatus can cause a light discomfort on the ear, at certain people. In this case, it is advisable to take a break and remove your hearing aid for an hour or two, ideally when interaction with others is reduced. Another solution is to have an optician make a spectacle arm into which your BTE can be slipped, which – if not to reduce the overall weight of the hearing aid and the spectacle arm – will at least make the system more ergonomic to use. On the other hand, it is also advisable, when you remove your glasses, to take care not to remove, at the same time, your hearing aid whose sound tube can easily get tangled up with the temples of the glasses : it is, indeed, quite common to hear users of behind-the-ear hearing aids complaining of having lost their hearing aid when removing their glasses.

If you wear glasses, it is recommended that you remove them when you put on your BTE hearing aid. This way, you can easily put on your hearing aid and adjust its position before you place the glasses on the hearing aid case. In the same way, when you want to remove your behind-the-ear hearing aids, make sure you first remove your glasses: this way, you can easily remove your hearing aids before replacing your glasses.

The in-the-ear (ITE / CIC) hearing aid and the pair of glasses

The in-the-canal (ITE / CIC) hearing aid does not pose any difficulty if the user already wears glasses : indeed, slipped into the auditory canal, this type of hearing aid does not interfere with the branch of the glasses and does not weigh on the auricle. Moreover, when the user removes his glasses, there is no risk of losing the hearing aid, which is not located behind the ear but in the ear canal.

Can we keep hearing aids on at night ? Can you sleep with a hearing aid ?

There is no point in wearing a hearing aid at night when you are sleeping. The primary purpose of a sound amplification system is to provide hearing comfort in everyday interactions, not while you sleep (unless you want to hear more of your spouse’s snoring ). So be sure to remove your hearing aids when you go to bed and clean them properly before putting them away in their storage box, so that they are in perfect working order and ready to be used the next morning when you wake up.

Wearing a mask with a hearing aid ? How do you wear a mask with hearing aids ?

In recent times, wearing a sanitary mask has become commonplace. There is no contraindication to wearing a mask with a hearing aid, however – as you may have gathered – there are some points to consider (especially if you already wear glasses and your hearing aid is a BTE).

The Behind-The-Ear (BTE) hearing aid and the sanitary mask

As we have seen, the behind-the-ear (BTE) hearing aid is positioned behind the pinna. So, if you are already wearing a pair of glasses and you add the thin strap of a sanitary mask on top of it, it can cause discomfort because all these elements weigh on the pinna. On the other hand, when putting on and taking off your sanitary mask, you must be careful not to accidentally remove your hearing aids in the process, at the risk of losing them. We remind you that the loss of hearing aids is not covered by their current insurance.

The In-The-Ear (ITE / CIC) hearing aid and the sanitary mask

Because the ITE / CIC hearing aid is positioned in the ear canal, it does not interfere with the use of a sanitary mask and does not require any additional attention from the user when the sanitary mask is put on or removed.

Can I wear a hearing aid while having a scan ?

It is requested that you remove your hearing aids during CT scans, MRI scans, X-rays, or any other similar examination, just as it is requested that you remove your jewelry. The interaction of metals and/or electronic components with the medical equipment used during these examinations could interfere with the results or not allow the optimal functioning of the machines during the examination. In addition, it could damage your hearing aids. Therefore, be sure to remove your hearing aids during a CT scan or similar examination.

How do I put a hearing aid in my ear ?

Whether you purchased your hearing aid from a hearing care professional or from a company known for selling pre-configured hearing aids, the process of putting your hearing aid in your ear is explained to you by the healthcare professional who sold you your hearing aid or is explained in the user manual that came with your purchase. We recommend that you pay attention to these explanations when they are provided to you and that you read the user manual carefully before using your hearing instruments.

Putting a Behind-The-Ear (BTE) hearing aid in your ear

To insert your RIGHT behind-the-ear hearing instrument into your RIGHT ear, follow these steps :

• Remove your eyeglasses and, if applicable, your face mask ;
• Hold the case of your hearing aid between the thumb and index finger of your right hand ; hold the sound tube between the thumb and index finger of your left hand ;
• Place the earmold of your hearing aid in your right ear and position it correctly in your ear ;
• With your right hand, gently pass the sound tube over the pinna of your right ear and finish the operation by positioning the hearing aid case behind the pinna of your right ear ;
• Adjust the positioning of your hearing aid (earmold, sound tube, casing) ;
• Check that the hearing aid is well positioned by mimicking chewing movements : if the hearing aid is well positioned and the earmold is properly occluding your ear canal, you should not hear any whistling. If not, adjust the position of the earmold in your ear and/or change its size ;
• Replace your glasses and, if applicable, your sanitary mask.
• Do the same with your LEFT BTE hearing aid for the LEFT ear.

Putting a In-The-Ear (ITE / CIC) hearing aid in the ear

To insert your RIGHT behind-the-ear hearing instrument into the RIGHT ear, follow these steps :

• Hold the removal pin of your hearing aid between the thumb and forefinger of your right hand ;
• With your left hand, gently pull your right earlobe down or your right earlobe up to clear your ear canal ;
• Insert the right ITE hearing aid into your right ear without fear of injury or going too far : as the ear canal narrows, the insertion of the hearing aid will naturally stop once the device is properly positioned ;
• Adjust the position of your hearing aid by pressing lightly on it, while continuing to clear your ear canal as explained above ;
• Check that the hearing aid is properly positioned by mimicking chewing motions : if the hearing aid is properly positioned and the earmold is occluding your ear canal properly, you should not hear any whistling. If not, adjust the position of the earmold in your ear and/or change its size ;
• Do the same with your LEFT canal hearing aid for the LEFT ear.

What are hearing aid earmolds used for ?

Silicone earmolds on a hearing aid have 3 main roles :

• To ensure a comfortable fit when using your hearing aid, thanks to the flexibility of silicone ;
• To allow the complete occlusion of the auditory canal, so that no whistling (Larsen effect) can be heard ;
• Allows the hearing aid to be held in the ear and thus avoid any risk of falling out.

Silicone earmolds are provided in different sizes with the purchase of pre-configured hearing aids, so that the hearing aid fits your ear canal immediately. As a general rule, if you purchase a hearing aid from a hearing care professional, the silicone earmold should be made by the hearing care professional as a custom fit for the hearing aid to the shape of your ear canal.

Why does my hearing aid whistle ?

Hearing aid whistling – called feedback or Larsen effect – can occur whether your hearing aid is a behind-the-ear or in-the-ear device. This whistling noise is a sign of one of three things :

• The silicone earmold is not sealing your ear canal,
• The hearing aid is not positioned properly in the ear,
• A wax plug is blocking your ear canal.

Larsen effect and in-the-ear (ITE / CIC) hearing aids

It is normal to hear a whistling sound when inserting an ITE hearing aid into the ear. The whistling stops as soon as the hearing aid is properly positioned and the silicone earmold is fully occluded. If the whistling persists, it may mean :

• That the earmold is not the right size : change the size of the earmold for a smaller or larger one and repeat the operation ;
• That the hearing aid is incorrectly positioned in your ear : take the time to familiarize yourself with your hearing aid and don’t be afraid to push it into your ear canal, the deeper it goes in, the better you will hear ;
• If there is an obstructive wax build-up in your ear canal : consult an ENT doctor who will remove the wax build-up. Do not try to remove the wax blockage yourself, as you may injure yourself. Earwax is usually removed naturally, through chewing movements. If you want to clean your ear canals, use water pans and avoid the use of cotton swabs, which “pack” the earwax in the ear and are the biggest source of wax plugs and perforated eardrums.

If you have purchased your in-the-ear hearing aid from a hearing care professional and your hearing aid keeps whistling, we recommend that you return to your hearing care professional to have your ear canal impression taken again and to change your earmold for a new one.

Larsen effect and behind-the-ear (BTE) hearing aids

If you experience feedback with a behind-the-ear hearing aid, which is whistling when you chew and not when you put the hearing aid in, the reasons are the same as mentioned above. If you have a pre-fitted hearing aid, be sure to change the earmold size and position the earmold correctly in your ear. If you purchased your hearing aid from a hearing care professional, we recommend that you return to your hearing care professional to have your ear canal impression taken and your earmold replaced with a new one.

How do you fit a hearing aid in the ear ?

There are two things that ensure that the hearing aid fits properly in your ear : the right earmold size for your ear canal and the right positioning of the hearing aid in your ear. For some people whose ear canals are too small, only BTE hearing aids (fitted or pre-configured) will satisfy the user, as the ITE cannot be inserted into the ear and cannot – by extension – fit in the ear. For people with an oversized ear canal, only a custom earmold fitting by a hearing care professional will be possible, regardless of the type of hearing aid (in-the-ear or behind-the-ear).